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					                           Quality Operating Process          Document No :
                                                              RML/BMW/01

Dr. Ram Manohar Lohia            Operating Protocol           Date of Issue :
Combined Hospital ,     Biomedical Waste Management Policy    15/1/2008
Lucknow




    Service Name :                 Bio medical waste management
                                     Operational Policy
    Date Created :                 15-01-2008


                                   Chief Medical Superintendent

    Approved By :
                                   Name       :

                                   Signature :


                                   Head–Hospital    Infection     Control

                                   Committee
    Reviewed By :
                                   Name :

                                   Signature :


                                   Director

    Issued By :
                                   Name :

                                   Signature :

                                   Senior Consultant - Pathologist

    Responsibility of Updating :   Name :

                                   Signature :




                                      0                      Operating Protocol
                             Quality Operating Process         Document No :
                                                               RML/BMW/01

Dr. Ram Manohar Lohia             Operating Protocol           Date of Issue :
Combined Hospital ,      Biomedical Waste Management Policy    15/1/2008
Lucknow




Page of Contents


Sl.Order Particulars
A           Purpose
B           Scope
C           Responsibility
D           Policy

               1. Classification of the Waste Generated

               2. Definition of Biomedical Waste

               3. Segregation of Biomedical Waste

               4. Sources of Waste in Hospital

               5. Guideline for Collection of Waste

               6. Guidelines for Transport of Waste

               7. Guideline for Storage of Waste

               8. Guideline for Safe Disposal of Waste

               9. Other reusable Waste




                                      1                       Operating Protocol
                                         Quality Operating Process                     Document No :
                                                                                       RML/BMW/01

 Dr. Ram Manohar Lohia                       Operating Protocol                        Date of Issue :
 Combined Hospital ,                Biomedical Waste Management Policy                 15/1/2008
 Lucknow

A.      Purpose : The purpose of this waste management policy is to outline safe and efficient practices
        for the segregation, store and disposal of biomedical and general waste generated by the hospital.

B.      Scope : Hospital Wide


C.      Responsibility : Head – Infection Control , Infection Control and Ward Nursing Staff


D.      Policy:


1.Classification of the waste generated :
Hospital Waste: All waste coming out of Hospital consist of the following:

     1. 80% is non-hazardous waste .
     2. 15% is infectious waste .
     3. 5% is non-infectious but hazardous waste .

Infectious waste includes all kinds of waste that may transmit viral, bacterial or parasitic diseases to human
beings.

Pathological waste include human tissues, organs and body parts and body fluids that are removed during
surgery or autopsy or other medical procedures and specimens of body fluids and their containers

2.Definition of Biomedical Waste :

Biomedical Waste: Bio-medical waste means any waste which is generated during the diagnosis,treatment
or immunization of human beings or from research activities pertaining there to or in production or testing
or biologicals (preparations from organism or microorganism or product of metabolism and bio chemical
reaction intended for use in diagnosis, immunization or treatment.

Identifying waste: Classified into two categories:

          Infectious
          Non-infectious
Both infectious and non-infectious waste may either be biodegradable, or non-biodegradable.

Biodegradable Waste: That which is capable of being decomposed and broken down by biological agents,
like bacteria.

Non-biodegradable Waste: That which cannot be broken down by biological agents. Example: Plastics.

I. Infectious waste:

Pathological waste including tissues, organs, blood and body fluids. Syringes, IV tubing, blood bags and
other items contaminated with blood and body fluids like plaster, casts, Human anatomical and surgical
waste, body excretions needles, IV canulas, cotton, swabs, bandages, mops etc.




                                                      2                              Operating Protocol
                                            Quality Operating Process                 Document No :
                                                                                      RML/BMW/01

 Dr. Ram Manohar Lohia                         Operating Protocol                     Date of Issue :
 Combined Hospital ,                  Biomedical Waste Management Policy              15/1/2008
 Lucknow


ii. Non-infectious waste:

85% of the entire hospital waste.

Classified into

a. Kitchen waste:

Food, peels, teacups, foil, plastic, fruit vegetable leftovers.
Kitchen waste 2 categories;
Bio-degradable waste and Non-biodegradable waste.

b. General office waste:

Wrapping paper, office papers, cartons, packing materials, plastic sheets, and newspapers.

3.Segregation of Hospital Waste:

Segregation of wastes is the most important prerequisite in the process of wastes management.
Segregation of waste allows special attention to be given to the different categories of wastes and thereby
reducing the health risks as well as cost of handling and disposal.
While separating waste it is especially important to separate infectious waste from non-infectious waste. If
mixed; non-infectious also becomes infectious.



                  Color                             Container                          Category
Blue                                   Blue plastic bag in plastic bin     Broken Glasses , Needles ,
Sharp                                                                      Syringes etc
Red                                    Red plastic bag in plastic bin      Soiled Cotton , Gauzes ,
Infectious Non sharp                                                       Catheters , IV tubing etc
Yellow                                 Yellow plastic bag in plastic bin   Human tissues, organs, body
(Organ and tissue waste)                                                   parts, placenta, pathological and
                                                                           surgical waste, microbiology and
                                                                           biotechnology waste
Black                                  Black bag in plastic bin            General paper waste; and also
(General Waste)                                                            kitchen waste, that is disposed
                                                                           separately.


Segregation should happen at source with proper containment, by using different color coded bins for
different categories of waste.




                                                         3                           Operating Protocol
                                         Quality Operating Process                   Document No :
                                                                                     RML/BMW/01

 Dr. Ram Manohar Lohia                      Operating Protocol                       Date of Issue :
 Combined Hospital ,               Biomedical Waste Management Policy                15/1/2008
 Lucknow


4. Sources of Waste in the Hospital:

      ER – Red, Blue, Yellow, Black, and sharps.
      Pharmacy – Black.
      Lab – Red, Blue, Yellow, Black and sharps.
      Day Care – Red, Blue, Black and sharps.
      OT – Red, Blue, Yellow, Black and sharps.
      Dialysis – Red, Blue, Black and sharps.
      Radiology – Red, Blue, Black and sharps.
      Kitchen – High volume biodegradable wet garbage.
      OP waiting areas - Black.


5. Guidelines for Collection of Waste:

      Waste will be collected by housekeeping at the respective department in two shifts; morning and
       evening (or as required) using wheel-able garbage bins except in OT where the waste would be
       collected after every operation.
      Wheel-able trolleys will be used for transportation of waste from various areas of the hospital to the
       temporary waste storage area of the hospital.
      Housekeeping staff will: wear heavy duty gloves, wear a mask, while collecting waste.
      Waste will be collected in two shifts or when waste bin or sharps bin is ¾ full.
      Before plastic bags are collected, they must be properly tied in a manner that does not allow for any
       leaks or spillage.


6. Guidelines for Transport of Waste :

      When waste is collected, from a particular area, it will be wheeled downstairs to the basement
       where it will be weighed and transferred to the appropriate colored bin in the waste holding room.
       This will be done each shift.
      A large plastic bag will be used to line the wheel-able bin to prevent any liquid leaks from the waste
       bags from soiling the bin.
      This plastic bag is to be replaced each shift.
      The wheel-able bin will be cleaned and disinfected with Sodium hypochlorite solution once in 24
       hrs. This will keep the bin sterile and odorless.
      While transferring waste to storage bins in the basement, housekeeping staff will wear a protective
       mask, heavy duty gloves, and rubber boots.


7. Guidelines for Storage of Waste:

      Blue, Red Yellow and Black waste will be held in the bins kept permanently in waste holding room.
       Sufficient no. of bins will be kept to store waste for a period of 48 hrs.
      Kitchen waste will be placed in designated bins and will be stored for a maximum of 48 hrs.
      All plastic bags are to be tied securely and the lid of the bin is to be firmly shut.




                                                     4                              Operating Protocol
                                        Quality Operating Process                     Document No :
                                                                                      RML/BMW/01

 Dr. Ram Manohar Lohia                      Operating Protocol                        Date of Issue :
 Combined Hospital ,               Biomedical Waste Management Policy                 15/1/2008
 Lucknow



8. Guidelines for the Safe Disposal of Waste: Waste will be handed over to the outsourced agency in the
   following manner:

      All waste held in the storage bins will be wheeled up to the garbage truck itself. This will be done by
       the hospitals housekeeping staff.
      Waste plastic bags, whether Red, Blue, Yellow or Black will not be opened in the collecting truck,
       but will be stored and transported out of the hospital premises directly.
      The contractors’ garbage handlers will wear heavy duty gloves, mask, and rubber boots while
       transferring waste from the hospitals bins to the truck.
      Transfer of waste to the truck will be overseen by security.
      Security staff will maintain a log book which will document, the date, and weight of the waste
       collected by the contractor.
      Waste will be disposed of every 48 hrs.

9. Other Re-usable waste

      Fixer from the Radiology department is removed once in 3 to 4 weeks. This fixer liquid is
       transported in a closed container by housekeeping staff to a designated area of the hospital under
       the supervision and guidance of Radiology Staff.

      Glass and cardboard from the kitchen are to be stored for a month and sold for recycling.




                                                     5                              Operating Protocol